| CT引导下经皮肺穿刺术在高原地区肺结核诊断中的应用 |
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| 引用本文： | 格桑德吉,李伟,余小华,郇霞,江阿次仁,次仁卓嘎,姚彦鹏.CT引导下经皮肺穿刺术在高原地区肺结核诊断中的应用[J].中华全科医学,2017,15(8):1305-1307. |
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| 作者姓名： | 格桑德吉 李伟 余小华 郇霞 江阿次仁 次仁卓嘎 姚彦鹏 |
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| 作者单位： | 1. 山南市人民医院呼吸科, 西藏 山南 856005; |
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| 基金项目： | 安徽省科技厅重点实验室绩效考核项目（1206-c-0805025）；安徽省科技攻关项目（12010402127） |
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| 摘 要： | 目的 评价CT引导下经皮肺穿刺术在高原地区肺结核的诊断价值。 方法 回顾性分析2016年10月—2017年3月期间接受CT引导下经皮肺穿刺并最终确诊的22例患者的临床资料。 结果 22例患者中,男性15例,女性7例,年龄28~71岁,平均年龄(44.7±14.8)岁。合并COPD病史11例(50.0%),高原性心脏病10例(45.5%),2型糖尿病9例(40.9%),高血压病7例(31.8%)。发热7例(31.8%),咳嗽、咳痰12例(54.5%),咯血8例(36.4%),胸痛8例(36.4%),盗汗7例(31.8%),消瘦10例(45.5%),纳差8例(36.4%),无症状(体检发现)9例(40.9%)。22例患者全部穿刺成功,CT引导下经皮肺穿刺活检成功率为100%(22/22),CT穿刺共确诊20例,穿刺物病理阳性率90.90%(20/22),穿刺物抗酸染色阳性率为18.2%(4/22),二者相比差异有统计学意义(χ2=20.625,P<0.05)。本组共有5例患者出现轻微不良反应。气胸发生率9.1%(2/22),吸氧休息后自行吸收。咯血发生率13.6%(3/22),无大咯血发生。 结论 CT引导下经皮肺活检操作简单、安全性高,对高原地区肺结核的诊断具有重要应用价值。
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| 关 键 词： | 高原 肺结核 CT引导下经皮肺穿刺 |
| 收稿时间： | 2017-05-15 |
Clinical application of CT-guided percutaneous lung biopsy in the diagnosis of pulmonary tuberculosis in high altitude area |
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| Affiliation: | 1. Department of Respiratory Disease, the People' s Hospital of Shannan, Shannan, Tibet 856005, China |
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| Abstract: | Objective To explore the clinical value of CT-guided percutaneous lung biopsy in the diagnosis of pulmonary tuberculosis in high altitude area. Methods The clinical data of 22 cases of pulmonary tuberculosis confirmed by CT-guided percutaneous lung biopsy between October, 2016 and March, 2017 were retrospectively analyzed. Results There were 15 males and 7 females, aged 28-71 years, with an average age of (44. 7 ±14. 8) years. 11 cases complicated with the history of COPD (50%), 10 cases with high altitude heart disease (45. 5%), 9 cases with type 2 diabetes mellitus (40. 9%), and 7 cases with hypertension (31. 8%). The clinical manifestation included 7 cases of fever (31. 8%), 12 cases of cough and sputum (54. 5%), 8 cases of hemoptysis (36. 4%), 8 cases of chest pain (36. 4%), 7 cases of night sweats (31. 8%), 10 cases of loss of weight (45. 5%), 8 cases of loss of appetite (36. 4%), 9 cases without symptoms (physical examination found, 40. 9%). All the 22 patients had successful puncture, and the success rate of CT-guided percutaneous lung biopsy was 100% (22/22). The positive rate of pathologic diagnosis was 90. 90% (20/22). The positive rate of acid-fast staining for puncture fluid was 18. 2% (4/22). There was significant difference between the two groups (χ2=20. 625, P < 0. 05). A total of 5 patients with mild complication were observed. The incidence of pneumothorax was 9. 1% (2/22), pneumothorax were automatically absorbed after oxygen uptake and rest. The incidence of hemoptysis was 13. 6% (3/22), and no fatal hemoptysis occurred. Conclusion The CT-guided percutaneous lung biopsy is a safe and effective means in the diagnosis of pulmonary tuberculosis in high altitude area. |
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